Competence for internship: perceptions of final-year medical students.

CONTEXT: A 'new', problem-based medical curriculum was introduced at the University of Cape Town (UCT) in 2002. The objective of this study was to assess the perceptions of competence for internship and the factors influencing competence of final-year medical students. METHODS: Eighteen focus groups were conducted (six per year) with UCT final-year medical students in 2007 (n =27), 2008 (n =27), and 2009 (n =30). Guide questions covered student's expectations of internship, perceptions of competence, priorities regarding competence, and factors influencing competence. RESULTS: Participants felt generally positive about and competent to enter internship, and the transition into internship was characterized as having both personal and professional components. Participants identified interpersonal skills, theoretical grounding, and intellectual ability as strengths, and lack of basic science knowledge and certain procedural skills as weaknesses. Factors influencing competence included personal initiative, motivation, and clinical exposure. Curriculum strengths identified were teaching of interpersonal skills and development of students as lifelong learners. The main weaknesses identified were teaching and assessment of basic sciences, and problem-based learning (PBL). Overall, the participants felt generally positive about internship and the 'new' curriculum, and felt generally competent to enter internship. Their responses highlight the role of confidence in the development of competence. CONCLUSIONS: These findings highlight the complexities surrounding perceptions of students about competence and views about the content and methodology of the learning. Perceptions of students regarding competence are an important indicator of the attainment of intended curriculum outcomes, and provide valuable information for the improvement of curriculum.

Cross-sectional survey of growth of urban and rural "cape coloured" schoolchildren: anthropometry and functional tests.

The patterns of physical growth (height, weight, length of body segments, circumferences, and widths) and function (grip strength, reflexes, and pulse rates) of "Cape Coloured" schoolchildren were studied. Urban and rural groups were selected with maximum contrasting socioeconomic status (SES). Data were collected between 1986 and 1988 and included 906 males and 1,068 females of high SES between 5 and 20 years in the Cape Town urban area and 834 males and 940 females of low SES between 5 and 19 years in the Little Karoo region. Means and standard deviations of 20 characteristics by age are presented separately for males and females and urban and rural groups. The heights and weights of prepubertal urban children match American reference data, but postpubertally they decline somewhat, whereas these measurements of the rural children consistently lie ∼1 standard deviation below the urban group. Skinfold thicknesses of urban children match or exceed the American reference, implying that their nutritional needs are being met well. Functional indicators of rural children are much poorer than those of urban children. The results of the urban children may provide a target for the improvement in growth status of rural children. Am. J. Hum. Biol. 10:73-85, 1998. © 1998 Wiley-Liss, Inc.

Functional anatomy of the penguin flipper.

This study investigates the functional anatomy of the flipper of the jackass penguin (Speniscus demersus). The flippers of birds (n = 15) were dissected and described. Several adaptations from the typical avian wing were noted and reasons were proposed for these. The conclusion is that the osteological and myological adaptations of the flipper are designed to enable the penguin to progress very effectively through water, while the vascular adaptations provide a highly efficient mechanism for thermoregulation.

Osteochondrodysplasia in a litter of Bulldog puppies.

A 1-month-old male Bulldog pup was presented with severe dyspnoea and was also unable to stand. Radiographs revealed a considerable dorsoventral flattening of the thoracic cavity, resulting in a reduced intrathoracic volume. The scapula of each foreleg was malpositioned on the thorax, resulting in the inability to adduct the legs and carry the body weight. The clinical signs are typical of an animal suffering from osteochondrodysplasia.

A case of a highly invasive carcinoma of a salivary gland in a crossbred dog.

A 13-year-old male crossbred dog was presented with a unilateral swelling of the facial region, severe pain when the mouth was opened, and chronic otitis. Upon palpation it appeared that the right mandible had been fractured. At necropsy the head revealed a large tumour which had invaded the mandible and had caused areas of osteolysis. Histopathology revealed a solid highly anaplastic carcinoma of one of the serous salivary glands.

A case of dysuria as a result of a communication between the urinary bladder and corpus uteri in a Cairn Terrier.

A 61/2-month-old Cairn Terrier, considered to be a bilateral cryptorchid male, was presented with dysuria and urinary incontinence. This was found to be due to a congenital communication between the urinary bladder and corpus uteri and resulted in distention of the uterus with urine which could not be voided. An ovariohysterectomy was performed. The dog was found to be a gentic female with what resembled external male genitalia, i.e. a female pseudohermaphrodite.

The surgical repair of atresia ani in a Dobermann bitch.

The surgical repair of atresia ani accompanied by a large rectovaginal fistula was successfully performed in a 4-month old Dobermann bitch. As a young pup, the dog had been able to pass liquid stool through the vagina via a rectovaginal fistula, but the gradual change to a adult diet had resulted in considerable obstipation and tenesmus. The operation was performed experimentally, since the dog would have had to have been euthanased at this stage, and its success has allowed the dog to continue a satisfactory existence.

Fetal heart failure in a poodle due to widespread metastatic malignant haemangioendothelioma.

An elderly male Poodle was presented with haematuria, syncopy, a heart murmur and varying other symptoms which were all treated unsuccessfully. They were linked on post-mortem examination to a widely disseminated metastatic malignant haemangioendothelioma.

The development of the sulci and gyri of the bovine cerebral hemispheres.

This study contributes to the existing knowledge and includes a complete description of the gyri and sulci of the bovine cerebral hemisphere, the chronological order of appearance of these sulci and gyri and the ages at which the sulci and gyri reach their final pattern as seen in the bovine adult. The research was undertaken because this specific area has not been covered by anatomists in any depth. The results of this study will contribute to the more complete descriptions of the anatomy of the bovine adult, as well as of the embryological development of the animal. A number of bovine embryos and fetuses were collected from the abattoir. Serial sections of the embryos were studied histologically, while the brains of the fetuses were examined macroscopically or with a dissection-microscope. Up until day 58 the cerebral hemisphere is smooth. Then an indentation appears which marks the position of the Fissura sylvia. The Sulcus rhinalis lateralis appears at day 68. At day 90 the following grooves are visible: the Sulcus suprasylvius, the Sulcus cinguli, the Sulcus splenialis, the Sulcus genualis, and the Sulcus corporis callosi. At this age, all the gyri associated with these sulci develop, although the gyri are well developed only after the grooves have formed. At day 110 the Sulcus ectosylvius, the Sulcus marginalis, and the Sulcus presylvius are visible, once again with their associated gyri appearing a short time thereafter. At day 130 the following grooves are visible: the Sulcus coronalis, the Sulcus cruciatus, the Sulcus ansatus, and the Sulcus endomarginalis. The cerebrum of the foetus at this stage has well developed gyri. At day 160 the Sulcus proreus, the Sulcus ectomarginalis, the Sulcus suprasplenialis, the Sulcus endosplenialis, the Sulcus calcarinus, and the Sulcus endogenualis have developed. The final groove to form is the Sulcus rhinalis medialis. Then the brain looks like that of the adult animal.

Average menarcheal age of higher socioeconomic status urban Cape coloured girls assessed by means of status quo and recall methods.

The age of the onset of menstruation has been determined for the urban middle-class Cape Coloured population. From 1987 to 1992 data were collected from 857 girls aged 8 to 20 years attending primary and secondary schools in Cape Town. The schools were specifically selected for the highest socioeconomic status (SES) of pupils' parents. Three-quarters of parents fell into the higher three categories of the 5-category SES standard. Girls were interviewed with respect to their menarcheal status and those who were postmenarcheal were also asked to report when they had started to menstruate. The probit analysis of the status quo data yielded average of 12.61 years and a standard deviation (s) of 1.25 years. The retrospective method was applied only to recall data of 258 girls falling into fully postmenearcheal categories (16-20 years). It yielded an average of 12.75 (s = 1.32), insignificantly different from that obtained from the probit analysis. The menarcheal age of higher SES Cape Coloured girls is significantly lower than that of white girls in Cape Town (13.30 years) and much lower than that of any group of black South African girls. It falls close to the lower limit of the range reported worldwide. Body heights, weights, and Body Mass Index indicate good growth status of girls studied.

Further studies on the month-of-birth effect on body size: rural schoolchildren and an animal model.

A previous study (Henneberg and Louw: Am. J. Hum. Biol. 2:227-233, 1990) showed that urban schoolchildren born between August and January were taller and heavier by 13 to 17% of the standard deviation (S) than those born in February to July. The study is now extended to 1,522 impoverished rural schoolchildren from the Little Karoo district of S. Africa and to 804 German Shepherd dogs kennelled at a breeding station in the Transvaal. The dogs provided a quasi-experimental model because for all of them nutrition and living conditions were practically identical throughout the year. The month-of-birth effect in the body weight of dogs was found to be stronger than that in urban children: dogs born between August and January were heavier by 22% of S than those born in February through July. In rural children the effect is present, but its magnitude is somewhat less and the peak is shifted by 2-3 months. Children born in May through October are 11% of S lighter than those born in November through April. It seems that living conditions characteristic of extreme poverty tend to diminish the effect. In both the animal model and rural children the month-of-birth effect decreases with advancing age and is more pronounced in males than in females. These findings are in agreement with previous observations in urban children from Cape Town. Since the living conditions of dogs and humans differ, as do the climatic conditions of Cape Town, Little Karoo and the Transvaal, it is surmised that the similarity of the effect may result from factors influencing the entire planet in a uniform way.